1427054758 NPI number — DR. CLIFTON D COKINGTIN M.D.

Table of content: DR. CLIFTON D COKINGTIN M.D. (NPI 1427054758)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427054758 NPI number — DR. CLIFTON D COKINGTIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COKINGTIN
Provider First Name:
CLIFTON
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427054758
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5520 COLLEGE BLVD
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66211-1658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-491-3737
Provider Business Mailing Address Fax Number:
913-469-6686

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5520 COLLEGE BLVD
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-1658
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-491-3737
Provider Business Practice Location Address Fax Number:
913-469-6686
Provider Enumeration Date:
06/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  04-24794 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102258 . This is a "BCBSKS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 18344010 . This is a "FREEDOM NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18344010 . This is a "BCBSKC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3115147010 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000314 . This is a "FAMILY HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 560000 . This is a "FIRST GUARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100138550D , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 203405428 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100138550C , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0808020 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18344010 . This is a "PHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 203405444 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4479577 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com